Cochrane Collaboration

About: Cochrane Collaboration is a nonprofit organization based out in Oxford, United Kingdom. It is known for research contribution in the topics: Systematic review & Randomized controlled trial. The organization has 1995 authors who have published 3928 publications receiving 382695 citations.

Non‐pharmacological interventions for treating chronic prostatitis/chronic pelvic pain syndrome

Abstract: Background Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common disorder in which the two main clinical features are pelvic pain and lower urinary tract symptoms. There are currently many approaches for its management, using both pharmacological and non‐pharmacological interventions. The National Institute of Health ‐ Chronic Prostatitis Symptom Index (NIH‐CPSI) score is a validated measure commonly used to measure CP/CPPS symptoms.

Prophylaxis against covid-19: living systematic review and network meta-analysis.

Abstract: Objective To determine and compare the effects of drug prophylaxis on SARS-CoV-2 infection and covid-19. Design Living systematic review and network meta-analysis. Data sources World Health Organization covid-19 database, a comprehensive multilingual source of global covid-19 literature to 25 March 2021, and six additional Chinese databases to 20 February 2021. Study selection Randomised trials of people at risk of covid-19 who were assigned to receive prophylaxis or no prophylaxis (standard care or placebo). Pairs of reviewers independently screened potentially eligible articles. Methods Random effects bayesian network meta-analysis was performed after duplicate data abstraction. Included studies were assessed for risk of bias using a modification of the Cochrane risk of bias 2.0 tool, and certainty of evidence was assessed using the grading of recommendations assessment, development, and evaluation (GRADE) approach. Results The first iteration of this living network meta-analysis includes nine randomised trials—six of hydroxychloroquine (n=6059 participants), one of ivermectin combined with iota-carrageenan (n=234), and two of ivermectin alone (n=540), all compared with standard care or placebo. Two trials (one of ramipril and one of bromhexine hydrochloride) did not meet the sample size requirements for network meta-analysis. Hydroxychloroquine has trivial to no effect on admission to hospital (risk difference 1 fewer per 1000 participants, 95% credible interval 3 fewer to 4 more; high certainty evidence) or mortality (1 fewer per 1000, 2 fewer to 3 more; high certainty). Hydroxychloroquine probably does not reduce the risk of laboratory confirmed SARS-CoV-2 infection (2 more per 1000, 18 fewer to 28 more; moderate certainty), probably increases adverse effects leading to drug discontinuation (19 more per 1000, 1 fewer to 70 more; moderate certainty), and may have trivial to no effect on suspected, probable, or laboratory confirmed SARS-CoV-2 infection (15 fewer per 1000, 64 fewer to 41 more; low certainty). Owing to serious risk of bias and very serious imprecision, and thus very low certainty of evidence, the effects of ivermectin combined with iota-carrageenan on laboratory confirmed covid-19 (52 fewer per 1000, 58 fewer to 37 fewer), ivermectin alone on laboratory confirmed infection (50 fewer per 1000, 59 fewer to 16 fewer) and suspected, probable, or laboratory confirmed infection (159 fewer per 1000, 165 fewer to 144 fewer) remain very uncertain. Conclusions Hydroxychloroquine prophylaxis has trivial to no effect on hospital admission and mortality, probably increases adverse effects, and probably does not reduce the risk of SARS-CoV-2 infection. Because of serious risk of bias and very serious imprecision, it is highly uncertain whether ivermectin combined with iota-carrageenan and ivermectin alone reduce the risk of SARS-CoV-2 infection. Systematic review registration This review was not registered. The protocol established a priori is included as a supplement. Readers’ note This article is a living systematic review that will be updated to reflect emerging evidence. Updates may occur for up to two years from the date of original publication.

Mammography Screening: Truth, Lies and Controversy

Abstract: Foreword by Iona Heath. Foreword by Fran Visco. Acknowledgements. Introduction. What it really means to be 'controversial'. Our collaboration with the media. Important issues in cancer screening. What it means 'to have cancer'. Overdiagnosis and overtreatment. Erroneous diagnoses and carcinoma in situ. Basic issues in cancer epidemiology. Randomised trials, observational studies and a little statistics. Why screening leads to misleading survival statistics. Why 10--year survival is also misleading. Does screening work in Sweden? Stonewalling the Cochrane report on screening. The Danish National Board of Health interferes with our report. Troubling results in the Lancet. The Canadian trials. Media storm. Email from researchers. Our collaboration with the trialists. Ten letters to the editor. Creative manipulations in Sweden. Peter Dean, a remarkable character. Bad manners also in Norway. Continued troubles in Denmark. Harms dismissed by the Cochrane Breast Cancer Group. The process with the Cochrane review. Of mites and men. Confusion over who is in charge. The Lancet publishes the harms of screening. Vitriolic mass email from Peter Dean. Beating about the bush in the United Kingdom. Condemnations in Sweden. Contempt of science in Denmark and Norway. Delayed media storm in the United States after our 2001 reviews. Miettinen and Henschke's cherry--picking in the Lancet. Additional reactions in the United States. The Danish National Board of Health circles the wagons. US and Swedish 2002 meta--analyses. US Preventive Services Task Force's meta--analysis. Nystrom's updated Swedish meta--analysis. Scientific debates in the United States. Peter Dean is wrong again. Multiple errors in the International Journal of Epidemiology. Publication of entire Cochrane review obstructed for 5 years. Cochrane editors stonewall our Cochrane review. Lessons for the future. Welcome results in France. Editorial misconduct in the European Journal of Cancer. Editorial misconduct. Threats, intimidation and falsehoods. Debates in the Scientist and the Cancer Letter. Tabar's 'beyond reason' studies. Criticism of our work in the Journal of Surgical Oncology. Other observational studies of breast cancer mortality. The United States and the United Kingdom. Denmark, Lynge's 2005 study. Denmark, our 2010 study. Overdiagnosis and overtreatment. Cancers that regress spontaneously. The 1986 UK Forrest report. Overdiagnosis in the randomised trials. Systematic review of overdiagnosis in observational studies. Observational studies from Denmark and New South Wales. The doubt industry. Duffy's studies on overdiagnosis. Lynge's studies on overdiagnosis. Carcinoma in situ and the increase in mastectomies. Ad hominem attacks: a measure of desperation? UK statistician publishes in Danish. Inappropriate name--dropping. Further ad hominem arguments. Lynge's unholy mixture of politics and science. Ad hominem attacks ad infinitum. US recommendations for women aged 40 - 49 years. What have women been told? Website information on screening. Invitations to screening. A scandalous revision of the Danish screening leaflet. Our screening leaflet. Breast screening: the facts, or maybe not. American Cancer Society. Information from other cancer societies. Getting funding or not getting funding. What do women believe?. Extraordinary exaggerations. What is the ratio between benefits and harms? Duffy's 'funny' numbers. Exaggerating 25--fold. The exaggerations finally backfire. The ultimate exaggeration. Tabar threatens the BMJ with litigation. Falsehoods and perceived censorship in Sweden. Celebrating 20 years of breast screening in the United Kingdom. Can screening work? Plausible effect based on tumour sizes in the trials. Lead time. Plausible effect based on tumour stages in the trials. No decrease in advanced cancers. Where is screening at today? Problems with reading mammograms. False promises. Important information is being ignored. Beliefs warp evidence at conferences. Does breast screening make women live longer? Where next? Is screening a religion? A press release from Radiology that wasn't. Has all my struggle achieved anything? Why has so much evidence about screening been distorted? Time to stop breast cancer screening. Appendix 1: Tabar's explanations in the Cancer Letter and our replies. Appendix 2: Our 2008 mam-mography screening leaflet. Appendix 3: The press release Radiology withdrew at the last minute. Index.

Drug survival is not significantly different between biologics in patients with psoriasis vulgaris: a single-centre database analysis

Abstract: Summary Background Drug survival depends on several factors such as dosing, effectiveness, quality-of-life improvement and safety, and could be seen as an overall marker for treatment success. Such data for biologics in psoriasis treatment are sparse. Objectives To determine differences in drug survival between different biologics for psoriasis. Methods Drug survival, dosing, Psoriasis Area and Severity Index (PASI) and Skindex-29 at weeks 12 and 52, and adverse events of patients with psoriasis treated with a biologic registered in the local database of the Academic Medical Center, Amsterdam, were analysed. Patients were divided into those naive or non-naive for treatment episodes with biologics. Results Drug survival did not differ significantly for naive treatment episodes between the biologics (etanercept 85% to 64%, adalimumab 77% to 77%, infliximab 75% to 75% for year 1–4), or for non-naive treatment episodes (etanercept 86% to 42%, adalimumab 84% to 56%, infliximab 68% to 43% for year 1–4; ustekinumab 84% to 57% for year 1–3). The naive group showed better drug survival and PASI 75 response at week 12, although the difference was not significant. A similar improvement of mean ∆PASI and mean ∆Skindex-29 was observed at weeks 12 and 52 for all biologics for both groups, although no significant difference was seen between groups. Treatment termination was due mainly to nonresponse for all biologics. Conclusions There was no significant difference in drug survival, mean ∆PASI or Skindex-29 response at weeks 12 or 52 between the biologics or between the naive and non-naive groups. Treatment termination was due mostly to nonresponse. Sequential treatment with the available biologics can be effective.

Foodborne and Food-Handler Norovirus Outbreaks: A Systematic Review.

Abstract: Norovirus (NoV) is the commonest cause of gastrointestinal disease in the United Kingdom and in many developed countries, causing diarrhea and vomiting in millions of cases worldwide annually. Transmission is most often mediated from person to person. NoV infection has, however, additionally been associated with the consumption of food, either through the consumption of food contaminated at source such as seafood, berries, and salad, or as a consequence of the foodstuff being contaminated in some way by a food handler during processing or serving. A systematic review of outbreaks attributed to NoV between January 2003 and July 2017 was conducted to assess the contribution of food handlers to the burden of NoV, and to identify foods commonly associated with NoV outbreaks. A total of 3021 articles were screened, of which 27 met the definition of confirmed foodborne outbreaks and 47 met the criteria for definite food-handler NoV outbreaks. Of all food types, shellfish were implicated in the greatest number of definite foodborne outbreaks. Food handlers contributed to definite food-handler outbreaks involving a diverse range of foodstuffs and in a wide variety of settings, including weddings and military establishments. More genotypes of NoV were found in people who were ill than in samples from food and food handlers. The potential for both food products and food handlers to contribute to the burden of NoV infection is demonstrated conclusively.